MEDICARE: JEVS CARE AT HOME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care	29713601	PA
2	253Z00000X	In Home Supportive Care Agency	29713601	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417455734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEVS CARE AT HOME

Provider Business Mailing Address
First Line	:	9350 ASHTON RD RM 102
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-7401
Country	:	US
Telephone Number	:	267-298-1619
Fax Number	:

Provider Business Practice Location Address
First Line	:	6315 FORBES AVE STE B025
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-1731
Country	:	US
Telephone Number	:	412-742-4033
Fax Number	:

Authorized Official
Title or Position	:	VP ORGANIZATIONAL DEVELOPMENT
Name	:	ROBERT JAMISON
Credential	:
Telephone Number	:	267-298-1619

Provider Enumeration Date	:	02/01/2018
Last Update Date	:	07/11/2019

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Directions to “JEVS CARE AT HOME ” Practice Location

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